Lenschow Christina, Pistorius Regina, Meir Michael, Schlegel Nicolas
Klinik und Poliklinik für Allgemein‑, Viszeral‑, Transplantations‑, Gefäß- und Kinderchirurgie, Universitätsklinik Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.
Chirurgie (Heidelb). 2025 Jul 24. doi: 10.1007/s00104-025-02343-7.
The identification of the parathyroid glands during neck surgery can be challenging due to their variable anatomical location. Knowledge of embryonic migration, typical positions and vascular supply is therefore essential for successful surgery of the parathyroid glands. This narrative review article, supported by a systematic literature search, addresses these aspects in detail. Anatomical orientation along the recurrent laryngeal nerve and the inferior thyroid artery as key landmarks, followed by systematic cervical exploration, improves intraoperative detection rates of parathyroid glands. The anatomical variability is higher for the inferior than for the superior parathyroid glands. In cases of primary hyperparathyroidism, preoperative localization using high-resolution ultrasound and functional imaging techniques (e.g., choline positron emission tomography/computed tomography, PET/CT) enables focused parathyroidectomy, leading to a significant reduction of operation times and complication rates.
由于甲状旁腺的解剖位置多变，在颈部手术中识别它们具有挑战性。因此，了解胚胎迁移、典型位置和血管供应对于甲状旁腺的成功手术至关重要。这篇叙述性综述文章在系统文献检索的支持下，详细阐述了这些方面。沿着喉返神经和甲状腺下动脉作为关键标志进行解剖定位，随后进行系统的颈部探查，可提高术中甲状旁腺的检出率。下甲状旁腺的解剖变异比上甲状旁腺更高。在原发性甲状旁腺功能亢进的病例中，术前使用高分辨率超声和功能成像技术（如胆碱正电子发射断层扫描/计算机断层扫描，PET/CT）进行定位可实现有针对性的甲状旁腺切除术，从而显著缩短手术时间并降低并发症发生率。
